In a post published last week, this blog detailed a fledgling platform called Leapfrog, which assigns over 2,000 American hospitals letter grades based upon safety records and patient reviews. The goal of this system is to increase hospital transparency by publicizing and hopefully preventing recurring and preventable medical errors that kill half a million people every year. That article glossed over this staggering figure, which lends itself to a more detailed discussion in this week’s post.
First, let’s more closely analyze the figure cited above. The Journal of Patient Safety published a literature review in September 2013 that aimed to update the Institute of Medicine’s 1984 estimate that 98,000 Americans die each year from medical errors. Using New York state medical records from 2008 to 2011, researchers determined that while there may be “a lower limit of 210,000 deaths per year associated with preventable harm in hospitals,” the “true number of premature deaths […] was estimated at more than 400,000.” More specifically, they project a number around 440,000. Before this article was published, a 2011 study in the medical journal Health Affairs claimed that “adverse events in hospitals may be ten times greater than previously measured,” which means that about one in three hospital patients will be the victim of a medical error.
Perhaps more alarmingly, researchers in the Journal of Patient Safety review suggest that “serious harm seems to be 10- to 20-fold more common than lethal harm,” meaning that up to 8.8 million patients per year are seriously injured from preventable mistakes in American hospitals every year. The nonprofit Institute of Medicine, an independent, nonpartisan organization, based on fifteen-year-old figures much lower than current malpractice estimates, argues that a combination of additional care, lost income, and disability costs such hospitals up to $29 million every year.
So what kind of preventable mistakes are happening in hospitals across the country?According to a 2010 study published in JAMA Surgery, many of them are wrong-patient, wrong-site, and wrong-surgery mistakes, which are called “never events” in medical literature, as in, these types of errors should never happen. It turns out that such events occur with “a persisting high frequency”–up to forty times per week. This does not even take into account misdiagnoses or missed diagnoses, both of which are alarmingly prevalent in hospitals as well.
Medical errors are more common than many people previously assumed was the case. Another common misconception is the number of lawsuits (and, by extension, monetary awards) that results from such mistakes. In 2009, the nonpartisan Congressional Budget Office analyzed relevant figures and assessed that lawsuits related to medical negligence amount to one-half of one percent of all health care costs. Similarly, in 2011, the National Center for State Courts wrote, “In each state, medical malpractice cases represented well under 2 percent of all incoming civil cases, and less than 8 percent of incoming tort cases.” As for the allegation that frivolous lawsuits are out of control, Harvard researchers debunked this myth in The New England Journal of Medicine in 2006, writing that about 97 percent of cases are meritorious and that “Portraits of a malpractice system that is stricken with frivolous litigation are overblown.”
The figures cited above come from peer-reviewed studies in medical journals with no conflicts of interest and not from self-interested legal scholars or civil justice propagandists. But despite the inherent reliability of these documented medical errors many doubters will continue to dispute them. That is, until they realize that the civil justice system is the only thing standing between them and a system that can inflict harm upon them, often without consequences.